Permit A ELECTRICAL PERMIT -
CITY TIGARD RESTRICTED ENERGY
- I� DEVELOPMENT SERVICES PERMIT #: ELR2001 -00059
-I �! 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/12/01
SITE ADDRESS: 06825 SW SANDBURG ST PARCEL: 2S101 DD -00400
SUBDIVISION: SALEM FREEWAY SUBDIVISION ZONING: C -P
BLOCK: LOT: 001 JURISDICTION: TIG
Project Description: Tenant Improvement - Security System
aba Nb- s`foct- 031
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL: X
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
TOC MANAGEMENT SERVICES SONITROL PACIFIC
6825 SW SANDBURG STREET 1975 SW 6TH AVE
TIGARD, OR 97223 PORTLAND, OR 97201
Phone: 620 -1710 Phone: 223 -5822
Reg #: LIC 00053535
ELE 26370CLE •
FEES Required Inspections
Type By Date Amount Receipt Ceiling Cover
PRMT CTR 3/12/01 $75.00 ' 2720010000 Wall Cover
5PCT CTR 3/12/01 $6.00 2720010000 Elect Final
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
Issued by Permittee Signature
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale. lease, or rent.
OWNER'S SIGNATURE: DATE:
•
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
y Electrical Permit Application
Date received: ' Permit no. / DOCG Z •
gl . City of Tigard RE CE1V'�® Project/appl. no.: Expire date:
City ofTigard Address: 13125 SW Hall Blvd, Tigar OR 97223 Date issued: By: I Receipt no.:
Phone: (503) 639 -4171 n 200
Fax: (503) 598 -1960 It kR. 1 +' Case file no.: Payment type:
Land use approval: apt�itt�"'� 0 Et.
T�'PE OF PERMIT ..
U & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement
0 New construction Addition /alteration/replacement 0 Other: 0 Partial
JOB SITE INFORMATION
Job address: 68 SW SA•I'I Tj s 1.4*4 s 1 Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: I Block: 'Subdivision:
Project name:70(' A?iN19{s, I Description and location of work on premises:
Estimated date of completion/inspection:
_ . .CON •RAC OR APP 1CATION , , : FEE
Job no: 6 ^ 031 �,.. Fee Max
Business name: S 1 Sc.`e L4 y Description Qty. (ea.) Total no. insp
S New residential - single ormuhi- family
Address:
5 t ) (. / dwelling unit. Includes attached garage.
City: 04 k Aim I StateO4 I ZIP: i ! 7 ! 1 Service ce f c l uded: 4
Phone: ,_, staff Fax:, , -e(, 0 . E -mail: q
CCB no.: � Elec. bus. lic. no: A -3 p Each additional 500 sq. ft. or portion thereof
Limited energy, residential 2
City / trOl Limited energy, non-residential 2
Lr v (4 Each manufactured home or modular dwelling
Sign ure of supervising electrician (required) Date 3 ., U M Service and/or feeder 2
Sup. elect. name (print): ,, ,, % C. 1 License no: ° 55 (0'7 i Services or Feeders — installation,
- alteration or relocation:
-. ..:> - .•.,., _ . . P ROPERTY'OWNER . 0
, 200 amps r less 2
Name (print): 201 amps to 400 amps 2
401 amps to 600 amps • 2
Mailing address: 601 amps to 1000 amps 2
City: I State: I ZIP: Over 1000 amps or volts 2
Phone: 'Fax: I E -mail: Reconnect only I
Owner installation: The installation is being made on property I own Temporary services or feeders - -
which is not intended for sale, lease, rent, or exchange according to installation, alteration, or relocation:
200 amps or less 2
ORS 447, 455, 479, 670, 701.
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2
ENGINEER Branch circuits - new, alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: I State: I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: Fax: E -mail:
Each additional branch circuit:
PLAN REVIEW' (Please check all that apply) Misc. (Service or feeder not included):
O Service over 225 amps - commercial 0 Health -care facility Each pump or irrigation circle 2
❑ Service over 320 amps - rating of 1 &2 ❑ Hazardous location Each sign or outline lighting 2
family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, a ��ry
❑ System over 600 volts nominal more residential units in one structure alteration, or extension* 1 - 2
❑ Building over three stories 0 Feeders, 400 amps or more *Description:
O Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above: .
O Egress/lighting plan 0 Other. Per inspection
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application
Permit fee $ -7 C ri,�
0 Visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $ try-'
Credit card number: / / within 180 days after it has been State surcharge (8 %) $
Expires accepted as complete. TOTAL $
Name of cardholder as shown on credit card
$
Cardholder signature Amount 440 -4615 (6/00/COM)
. Electrical Permit Fees: Limited Energy Fees: i
Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
/� Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total y Check Type of Work Involved:
Residential - per unit
1000 sq. ft. or less . $145.15 4 ❑ Audio and Stereo Systems
Each additional 500 sq. ft. or
portion thereof $33.40 1 ❑ Burglar Alarm
Limited Energy $75.00
Each Manufd Home or Modular ❑ Garage Door Opener
Dwelling Service or Feeder $90.90 2
Services or Feeders ❑ Heating, Ventilation and Air Conditioning System'
Installation, alteration, or relocation
200 amps or less $80.30 2
201 amps to 400 amps $106.85 2 ❑ Vacuum Systems
401 amps to 600 amps $160.60 2 —
601 amps to 1000 amps $240.60 2 Other
Over 1000 amps or volts $454.65 2 —
Reconnect only $66.85 2
Temporary Scr ices or Faedors
Installation, alteration, or relocation TYPE OF WORK INVOLVED - COMMERCIAL ONLY
200 amps or less $66.85 2 Fee for each system $75.00
201 amps to 400 amps $100.30 2 (SEE OAR 918 - 260 -260)
401 amps to 600 amps • $133.75 2
Over 600 amps to 1000 volts, Check Type of Work Involved:
see "b" above. ❑
Branch Circuits Audio and Stereo Systems
• New, alteration or extension per panel ❑
a) The fee for branch circuits Boiler Controls
with purchase of service or
feeder fee. n Clock Systems
Each branch circuit $6.65 2
b) i rie fee for branch circuits ❑ Data Telecommunication Installation
without purchase of service
or feeder fee. ❑ Fire Alarm Installation
First branch circuit $46.85
Each additional branch circuit $6.65 ❑
HVAC
Miscellaneous
(Service or feeder not included) ❑ Instrumentation
Each pump or irrigation circle $53.40
Each sign or outline lighting $53.40 ❑ Intercom and Paging Systems
Signal circuit(s) or a limited energy
panel, alteration or extension $75.00
Minor Labels (10) $125.00 ❑ Landscape Irrigation Control
Each additional inspection over El Medical
the allowable in any of the above
Per inspection $62.50
Per hour _ $62.50 ❑ Nurse Calls
In Plant $73.75 ❑
Outdoor Landscape Lighting
Fees:
❑ Protective Signaling
Enter total of above fees $
8% State Surcharge $
n Other
Number of Systems
25% Plan Review Fee
See "Plan Review" section on $
front of application.
* No licenses are required. Licenses are required for all other installations
f
Total Balance Due $ Fees:
El Trust Account # Enter total of above fees $ .
8% State Surcharge $
Total Balance Due $
i:\dsts \forms \etc - fees.doc 10/09/00
I 7y7 P
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
�/, � G BUP
Date Requested % AM PM BLD
•
Location one f S (56.).-d Suite MEC
Contact Person Ph 70/ Z/ 7S" PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR 27C - 0 0 Z97
Footing Access:
Foundation I°PS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear C� /� 00 — C J 2 2/
O
Framing
Insulation
Drywall Nailing / - O 0 0 4. 0
Fire wall ` �0, O 0 0 l
Fire Sprinkler
Fire Alarm /
Susp'd Ceiling D [.ti !/ B 6 a,
Roof
Misc:
Final
PASS PART FAIL
PLUMBING f /O s P q 1 1 l_, 1
Post & Beam
Under Slab
Top Out
Water Service (� P pl q 4-A
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas
Smoke e Dampers
Final
PASS PART FAIL
- 1LECTRICB?
- Service
Rough In
UG /Slab
ow Volt
Fire Alarm
- ART FAIL
S
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other D ate it- ,.z. / Inspector ��, _ �' Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.